160th Anniversary

Contact Information

First Name *

Last Name *

Street Address *

Address Line 2

City *

State *

Zip Code *

Phone Number *

Email Address *

Affiliation

Unit or Sutlery *

I am Representing

	Army				Branch				Other
	Union	USCT	Confederate		Artillery	Infantry	Cavalry		Sutler	Civilian	1st Person Presenter
Please check all that apply	Union	USCT	Confederate		Artillery	Infantry	Cavalry		Sutler	Civilian	1st Person Presenter

Trailers
So that we can prepare for parking, please advise the number, size and type of trailer(s) your expect your unit to bring. *

Cavalry:

# Mounted?

# of Horses

Please submit a current coggins test for each horse attending

COGGINS certificates must be in hand no later than May 26.

Artillery:

List artillery piece(s) your unit is bringing

BOUNTY ISSUED FOR FIRST 8 FULL SIZED GUNS REGISTERED.

REGISTRANTS

Registration fee is $20. List name, rank and email address of every registrant (including yourself.)
A 160th Anniversary t-shirt is included with each registration.
Please indicate size for each registrant. Sizes are Adult XS, S, M, L, XL, 2XL, 3XL. 🛈

	First	Last	Rank	Email	T-shirt Size
1.	First	Last	Rank	Email	T-shirt Size
2.	First	Last	Rank	Email	T-shirt Size
3.	First	Last	Rank	Email	T-shirt Size
4.	First	Last	Rank	Email	T-shirt Size
5.	First	Last	Rank	Email	T-shirt Size
6.	First	Last	Rank	Email	T-shirt Size
7.	First	Last	Rank	Email	T-shirt Size
8.	First	Last	Rank	Email	T-shirt Size
9.	First	Last	Rank	Email	T-shirt Size
10.	First	Last	Rank	Email	T-shirt Size
11.	First	Last	Rank	Email	T-shirt Size
12.	First	Last	Rank	Email	T-shirt Size

Payment

# of Registrants *

	Adult Reenactors/Civilians/Living Historians, etc.
	USCT Reenactors/Living Historians
	Youth - 12 and Under
	Weitzel's Staff/Fort P. Planning Committee
	MEDIA

Saturday Blue & Gray Dinner catered by Southern Q

# of Dinner Tickets *

Dinner Tickets

NOTE: Please place a 0 in any box that does not apply to you.

Problems with or questions about registration? Contact info@fortpocahontas.org.

Links to electronic waivers will be emailed to all paid registrants before the event.

E-signature required for admittance.

Thank you for supporting the preservation and interpretation of Fort Pocahontas!